Individual
BECKY S GOOD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
CFNP
Contact information
Practice address
1500 SALEM ST, LAFAYETTE, IN 47904-2164
(765) 448-8000
Mailing address
250 N SHADELAND AVE, INDIANAPOLIS, IN 46219-4959
Taxonomy
Speciality
Code
Description
License number
State
363LF0000X
Family Nurse Practitioner
Primary
71001987A
IN
363LP2300X
Primary Care Nurse Practitioner
71001987A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000372083
ANTHEM PROVIDER NUMBER
IN
05
—
200532730
—
IN
01
—
9397718
PHCS PID NUMBER
IN
Enumeration date
03/23/2006
Last updated
06/26/2023
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